My Opinion: Ina May Gaskin and the Battle for at-Home Births in The NYTimes

I just read this very interesting, well-written article in the NY Times but I take slight offense that it is sub-titled Mommy Wars: The Prequel. The piece is a profile of Ina May Gaskin who runs a safe haven in Tennessee for women who want to have an “at-home” or midwife-assisted, non-hospital birth and her efforts to allow this to be a valid choice for all women. This article has nothing to do with the Mommy Wars (which the media considers the “fight” between stay at home mothers (SAHMs) and working moms). But adding that little subtitle makes it immediately seem like just an issue of personal opinion (although staying at home V.S. working is also increasingly not a personal decision either but a forced one) when it really has little to do with each person’s individual preferences; most women aren’t being allowed to have a preference – that’s the point.

In the comments for this article on the NY Times website, one person wrote that they felt it was “gross neglect” to allow women the option of a homebirth because of the risks. Her opinion arose mostly because her own homebirth had complications and she regretted her choice. It is so ridiculous when people take a single experience and decide that should apply to everyone. Yes, throughout history giving birth has been risky for both mom and baby. But it is also something that had to happen in order for every living person on earth to be standing here now and there are millions of us. Some people have died while bungee jumping, did that suddenly make it illegal? (and no, I’m not comparing giving birth to bungee jumping – I’m using an overly silly comparison of a single experience being the basis for a law or rule to apply to everyone).

Now some women may want an immediate epidural or a c-section and I think that’s fine, but shouldn’t the women who want to be allowed to labor for over 24 hours without being induced be allowed to do so too (crazy as that sounds to me), if neither mom nor baby is in danger? Knowing, as the medical community does, that all women labor differently and there’s nothing inherently abnormal about those differences (laboring for 2 hours versus 18, etc). Right now, many hospitals require women to be induced after X amount of time not progressing or if they are one to two weeks past their due date. And, as the Times article mentioned, 40 years ago women used to be strapped down and forced to have forceps-assisted deliveries – no questions asked. It sounds barbaric, and yet that was just 1 generation ago.

Here’s a great point though: considering that it is NOT disputed that the US is ranked 50th in the world for maternal mortality (that’s moms dying) and 41st in neonatal mortality (that’s baby dying) – whatever we’re doing doesn’t seem like it’s best for anyone. Shouldn’t that be impetus enough to look at what the countries with the lowest maternal and neonatal mortality rates are doing and try to copy them? That seems to me to be simple step in the right direction #1.

So whether you agree that a non-medicated, “psychedelic” birth option is something you want for yourself or not doesn’t really matter here. Why is a group of law-makers (usually all men) allowed to say all women MUST give birth in a hospital? (yes, in some states homebirth is illegal). That’s what the issue is here. And I’m thinking the reason, as with so many things, is just because of $$$ – think about the insurance companies that refuse to cover the cost of using birthing centers even though they are generally far less expensive than hospitals. It makes the most sense to have natural birth centers attached to hospitals so that women have options and if there is a problem, immediate help is available (simple step in the right direction #2), but that would, of course, involve the people running the hospitals to compromise.

If birth isn’t considered a medical procedure, a lot of things change. Yes, medical procedures and emergencies can arise from childbirth just like (and these are purposefully over simplified, silly comparisons again) someone who eats a lot of junk can have a heart attack, but we don’t ask every overweight person to eat their McDonalds in a hospital, just in case. And we don’t require all smokers to have screenings for lung cancer, though it’s been 100% proven that smoking is the leading cause. But a lot of the time childbirth is simple and uncomplicated. So why do we feel the need to force women to “protect” themselves against every possible calamity during childbirth and only childbirth? We don’t feel so strongly at any point afterwards – where are the clamors to require women to undergo mandatory pregnancy education (to try to prevent more pre-natal drinking and drug use) or mandatory parenting classes!? As a society, it seems like we’re working so hard to get these babies born, but after the baby exists, it’s not our problem. It doesn’t make any sense.

Great post. I agree with you on pretty much everything, and it’s not much better here in Australia either. Homebirth has been in the news this week for all the wrong reasons again. Funnily enough I also posted about this just a few hours ago!